Design of a Web-based individual coping and alcohol-intervention program (web-ICAIP) for children of parents with alcohol problems: study protocol for a randomized controlled trial

Prevalence of Parental Alcohol Problems among a General Population Sample of 28,047 Norwegian Adults: Evidence for a Socioeconomic Gradient

The aim of the study presented here was to estimate the prevalence of parental alcohol problems during childhood in a general population of Norwegian adults, and to investigate associations between parental alcohol problems during childhood and lower socioeconomic status in adulthood. This cross-sectional study recruited 28,047 adults (≥18 years) to an online health survey (Norwegian Counties Public Health Surveys). We evaluated demographic and socioeconomic measures and responses to a shortened version of the Children of Alcoholics Screening Test (CAST-6) scale to assess whether respondents perceived parental alcohol consumption during childhood as problematic. Respondents reported parental alcohol problems at a rate of 15.6%, but the experience was more prevalent among adults with a low education (20.0%), compared to those with intermediate (16.4%) or high educations (13.8%, χ2(2) = 87.486, p < 0.001), and it was more common among respondents with low economic capabilities (21.1%) compared to those with middle/high capabilities (14.2%, χ2(1) = 162.089, p < 0.001). Parental alcohol problems were most prevalent among respondents that received welfare benefits (24.5%). Multivariable logistic regression analyses revealed associations between parental alcohol problems and low socioeconomic status in adulthood; odds ratios (95% confidence intervals) ranged from 1.33 (1.25-1.42) to 1.89 (1.72-2.06). From a public health perspective, children who grow up with parental alcohol problems should be reached through both universal and selective interventions.

The effect of the severity of parental alcohol abuse on mental and behavioural disorders in children

Many studies have shown that children of alcohol abusing parents have a higher risk for mental and behavioural disorders compared to other children. Using a retrospective population-based cohort study, based on health care and social welfare registers that include children born in Finland in 1997 and their biological parents, we evaluated whether the severity of parental alcohol abuse is related to these disorders in children. We examined (1) differences in the incidence of mental and behavioural disorders over time among the children of parents with no alcohol problems, parents with less severe alcohol problems and parents with severe alcohol problems, and (2) associations between mother's and father's alcohol abuse and children's risk of disorders. Children were followed up until the age of 15. A diagnosis of mental or behavioural disorders during the follow-up was received by 15.4% of the boys and 9.0% of the girls. Both less severe alcohol abuse (HR = 1.36, 95% CI 1.14-1.61) and severe alcohol abuse (HR = 1.29, 95% CI 1.11-1.49) in mothers increased the risk of these disorders in their offspring. The corresponding figures among fathers were HR = 1.19, 95% CI 0.92-1.54 and HR = 1.16, 95% CI 1.02-1.32. Our results indicate that both maternal alcohol abuse and paternal alcohol abuse, regardless of severity, are associated with an increased risk of mental and behavioural disorders in children. It is crucial for professionals working with children to pay attention to all children whose parents have any alcohol abuse problems.

A web-based group course intervention for 15-25-year-olds whose parents have substance use problems or mental illness: study protocol for a randomized controlled trial

Background

Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents’ own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption.

Methods/design

The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15–25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants’ own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0) and three follow-ups after six (t1), 12 (t2), and 24 months (t3). Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF.

Discussion

Studies have revealed that the majority of children whose parents have substance use or mental health problems are not reached by the existing support. Thus, there is an urgent need to develop, implement, and evaluate novel intervention programs and disseminate successful programs to a broader audience. This study, investigating the effects of a web-based intervention, therefore makes an important contribution to this field of research.

Trial registration

ISRCTN10099247. Retrospectively registered on August 31, 2016.

Risk factors associated with mental health issues in adolescents: a integrative review

Objective: To identify the risk factors associated with mental health issues in adolescents. Method: An integrative review was conducted in four databases with publications from 2007 to 2013. The terms Adolescent and Mental Health were used to search adequate articles as DeCs/MeSH bases. Results: Publications were found in different journals in different fields of knowledge and the quantitative research was the most frequent. The mental health issues were categorized as individual factors; drug related factors, school factors, family factors, social factors and STDs/Aids related factors. The most addressed category was individual factors, with 23 publications. Conclusion: The integrative review allowed to point important questions to be addressed in preventive actions by the health professional, including the nurse, to create a space that works with risk conditioning factors in adolescents for mental health aggravation.


Evaluation of support group interventions for children in troubled families: study protocol for a quasi-experimental control group study

Background

Support groups for children in troubled families are available in a majority of Swedish municipalities. They are used as a preventive effort for children in families with different parental problems such as addiction to alcohol/other drugs, mental illness, domestic violence, divorce situations, or even imprisonment. Children from families with these problems are a well-known at-risk group for various mental health and social problems. Support groups aim at strengthening children’s coping behaviour, to improve their mental health and to prevent a negative psycho-social development. To date, evaluations using a control-group study design are scarce. The aim of the current study is to evaluate the effects of support groups. This paper describes the design of an effectiveness study, initially intended as a randomized controlled trial, but instead is pursued as a quasi-experimental study using a non-randomized control group.

Methods/design

The aim is to include 116 children, aged 7–13 years and one parent/another closely related adult, in the study. Participants are recruited via existing support groups in the Stockholm county district and are allocated either into an intervention group or a waiting list control group, representing care as usual. The assessment consists of questionnaires that are to be filled in at baseline and at four months following the baseline. Additionally, the intervention group completes a 12-month follow-up. The outcomes include the Strength and Difficulties Questionnaire (SDQ S11-16), the Kids Coping Scale, the “Ladder of life” which measures overall life satisfaction, and “Jag tycker jag är” (I think I am) which measures self-perception and self-esteem. The parents complete the SDQ P4-16 (parent-report version) and the Swedish scale “Familjeklimat” (Family Climate), which measures the emotional climate in the family.

Discussion

There is a need for evaluating the effects of support groups targeted to children from troubled families. This quasi-experimental study therefore makes an important contribution to this novel field of research. In the article various problems related to pursuing a study with children at risk are discussed.

Trial registration

ISRCTN52310507

Prevalence of adolescents who perceive their parents to have alcohol problems: A Swedish national survey using a web panel

Aims: The primary aim is to estimate the prevalence of Swedish adolescents who perceive their parent(s) to have alcohol problems. Additional research questions pertain to the prevalence of adolescents who think someone close to them drinks too much alcohol and if this has hurt them or caused them problems. Methods: A cross-sectional design was employed using a web-based survey targeted to 1000 Swedish 16–19-year-olds randomly selected from a web panel. The questionnaire included the CAST-6 scale, used to assess whether or not participants perceived their parents’ alcohol consumption as problematic, and questions relating to whether or not they think someone close to them drinks too much and if this has caused them problems. Data was weighted using a post-stratification procedure. Results: The proportion of adolescents classified as having parents with alcohol problems was 20.1%. Further, 44.0% reported that they think someone close to them drinks too much alcohol and 9.6% that this has hurt them or caused them problems. Conclusions: These results indicate that the problem is widespread. Our findings are similar to previous research where a more indirect methodology has been adopted, using either psychiatric interviews or self-reported alcohol consumption of adults, to estimate the magnitude of the problem.